PATTERNS OF GA-67-CITRATE ACCUMULATION IN HUMAN-IMMUNODEFICIENCY-VIRUS POSITIVE PATIENTS WITH AND WITHOUT MYCOBACTERIUM-AVIUM-INTRACELLULARE INFECTION

Infection with Mycobacterium avium intracellulaire (MAI) is an increas ingly important problem in patients infected with Human Immunodeficien cy Virus OW). The objective of this study was to identify whether spec ific patterns of accumulation of Ga-67 citrate occur in HIV antibody p ositive patients with disseminated MAI infection. A retrospective revi ew of Ga-67 scinigraphy was performed in 18 HIV antibody positive pati ents with MAI and 20 HIV antibody positive patients without MAI (who a cted as a control group). A wide range of abnormalities was seen in bo th groups of patients and no single abnormality was diagnostic of MAI. However MAI was likely (sensitivity 89%, specificity 70%) in the pres ence of two or more of the following; accumulation of Ga-67 in lymph n odes, paranasal sinuses or colon or reduced uptake in the bone marrow. No specific abnormality on Ga-67 scintigraphy in HIV antibody positiv e patients enables a diagnosis of MAI to be made. Subtle and non speci fic abnormalities of Ga-67 may be the only scintigraphic evidence of a ctive Mycobacterium avium intracellulare infection.